NIMH has identified research needs for older adults' mental health, including understanding factors that enhance access to mental health services (PA-03-014), given older adults' low service use. The broad, long-term objectives of this proposal are to identify attitudinal and social factors that predict depressed older adults' initiation and use of mental health services, in order to develop intervention strategies to improve service use. Because service utilization involves patterns over time that are influenced by numerous factors, experts have called for longitudinal, prospective research that assesses these multiple factors, including one understudied area, the person's social context. Therefore, the specific aims are to: 1) develop a description of formal mental health service utilization patterns over a six-month period for 150 community-dwelling older adults who screen positive for depressive symptoms in an aging services outreach program; and 2) investigate individual, social, and treatment factors that may prospectively predict service use patterns, as identified in Aim 1. A longitudinal design is being employed; participants complete monthly interviews regarding service utilization over a six-month period (in-person baseline, six telephone follow-ups). Baseline predictors (based on Pescosolido's network-episode model) include: attitudes (about aging, stigma, and treatment), coping styles, social support system (network size, advice), health background, prior service use, current symptoms, perceived barriers, and treatment system information. Social support, current symptoms, and perceived barriers are assessed at each follow-up. Participants will be recruited from a state- funded program that provides outreach, screening, and referrals for depressed older adults. The findings of this study will contribute to beginning to understand patterns over time of depressed older adults' mental health service use and relevant factors that could enhance service use. This information would inform the development of strategies to increase depressed elders' service use, such as motivational strategies for the individual, as well as family members. By improving depressed older adults' use of mental health services, a number of meaningful health-related outcomes could be achieved, including improved mood, functioning, quality of life, and physical health for the individual; reduced burden for caregivers; and reduced use of general medical services. [unreadable] [unreadable] [unreadable]